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iiiiiiiiiiiiiiiiiiiiiillillilign <br /> CITY OF ORONO * 2 0 1 S — 0 0 6 9 9 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 06/03/2015 <br /> • ORONO, MN 55356- <br /> 2 249-4600 FAX: (9 52) 249-4616 <br /> ADDRESS 4680 NORTH SHORE DR <br /> PIN 07-117-23-32-0050 <br /> LEGAL DESC TONKAVIEW GARDENS <br /> LOT 000 BLOCK 000 <br /> PERMIT TYPE MECHANICAL(>$500) <br /> PROPERTY TYPE RESIDENTIAL <br /> CONSTRUCTION TYPE FIREPLACE-GAS <br /> VALUATION $ 3,199.60 <br /> NOTE: HHT GAS FIREPLACE <br /> APPLICANT MECHANICAL 50.00 <br /> STATE SURCHARGE MECH(VALUATION) 1.60 <br /> FIRESIDE HEARTH&HOME MAIL-IN FEE 2.00 <br /> 2700 FAIRVIEW AVE <br /> ROSEVILLE, MN 55113 TOTAL 53.60 <br /> Payment(s) <br /> (651)633-2561 <br /> Minnesota State License#: mech-20512060 CREDIT CARD 4608 53.60 <br /> OWNER <br /> Midwest Custom Builders <br /> 719 HWY 10 NE#133 <br /> BLAINE, MN 55434- <br /> AGREEMENT AND SWORN STATEMENT <br /> The work for which this permit is issued shall be performed according to <br /> the approved plans and specifications,applicable City approvals,and the <br /> State Building Code. This permit is for only the work described and does <br /> not grant permission for additional or related work which requires separat <br /> permits. All provisions of laws and ordinances governing this type of wo <br /> shall be compied with whether or not specified herein.This permit will <br /> expire and become null and void if construction authorized is not <br /> commenced within 180 days of the date of issuance,or if construction is <br /> suspended for a period of 180 days at any time after work has commence <br /> The applicant is responsible for assuring all required inspections are <br /> requested in conformance with the State Building Code.This permit may e <br /> revoked at any tim or a cau�e. <br /> Applicant Permitee Signature Date Issued By Signature Date <br />